High-ventilation breathwork (HVB): best practices and ethical considerations – a survey study
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Qualitative |
|---|---|
| Intervention | High ventilation breathwork (HVB) |
| Topics | Breathwork |
| Key points | Argues that international HVB practice guidelines are too broad to give facilitators clear direction and that little is known about real-world HVB facilitation, creating ethical and safety concerns. Proposes an international survey of facilitators plus a review comparing HVB guidelines with psychotherapy standards to produce practical and ethical recommendations, a client checklist, and separate guidance for healthcare versus recreational settings. |
Abstract
In recent years integrative mind-body practices, such as high ventilation breathwork (HVB), have sparked considerable interest within psychotherapy research. HVB has a longstanding history, yet only in recent years has grown substantially in popularity, both as a potential therapeutic method within conventional Western health settings and as a wellness-oriented practice among the general public (Fincham, Kartar, et al., 2023). HVB has been practiced outside of regulated health-care systems for decades, leading to a distinct self-organized community and fragmented facilitation guidelines (ABA, 2011; GBPA, 2007; IBF, 2025; UKBA, 2025). With reported adverse effects and contraindications (Fincham, Kartar, et al., 2023; Havenith & Nemri, 2025), ethical concerns over the safety and well-being of clients reveal two critical literature gaps: First, international HVB practice-guidelines are broad and insufficient in providing clear guidance to HVB facilitators. Second, there is little insight into the real-world facilitation of HVB. These issues are particularly relevant for the potential integration of HVB into clinical healthcare settings over the long term. This thesis aims to bridge these gaps by synthesizing existing guidelines and supplementing them using best practices in psychotherapy as a blueprint for an ethically sound HVB facilitation. To accomplish this, an international survey will be conducted, collecting data on the current facilitation practices of HVB including compliance with recommended frameworks for HVB, such as provided by the GPBA and the IBF and broader, established frameworks from psychotherapy. Collected quantitative Data will be analyzed descriptively by means of frequencies, percentages, means, standard deviations and cross-tabulations. To explore potential patterns of facilitation, an exploratory cluster analysis may be conducted. For qualitative data, open-ended responses will be analyzed using structuring qualitative content analysis according to Kuckartz (2024). Aside of the data collection, existing HVB guidelines will be summarized, reviewed and compared to psychotherapy standards aiming to derive (in)consistencies between current practices and existing legal frameworks and resulting in international practical and ethical recommendations for the safe facilitation of HVB. A practical checklist will be developed for clients or those interested in trying HVB, empowering informed decisions by enabling the assessment of facilitators. Facilitators will receive recommendations for implementing core ethical principles in their practice. With long term integration into healthcare in mind, this resource will distinguish between healthcare and recreational settings. This approach advances ethical HVB facilitation and paves the way for its integration into regulated healthcare settings over the long term. Future research could also benefit from standardized HVB facilitation protocols, enhancing study comparability and reproducibility.